Psychological Therapies 601interfere with the use of this approach (Snyder et al., 2015). Bringing symptoms
under control is an important step in allowing a person to function normally in the
social world, and behavior therapies are a relatively quick and efficient way to elimi-
nate or greatly reduce such symptoms. However, some behavioral paradigms are not
simple to establish or continually implement, and steps have to be taken so adaptive
behaviors can be maintained and generalized to other situations and environments,
such as the family and the individual ’s culture (Prochaska & Norcross, 2014). Others
are easier to implement and may in fact not require extensive training to be success-
ful. For example, behavioral activation is an effective intervention for depression that
is relatively simple to implement, even by nonspecialists, and it has been shown to
be either comparable or superior to antidepressant medication in the short term and
superior to cognitive therapies (Dimidjian et al., 2006; Ekers et al., 2014). Further-
more, EX/RP for OCD, PE for PTSD, and other exposure-based approaches may pos-
sibly be enhanced, such as by using two fear-provoking stimuli at the same time to
facilitate learning during exposure (Culver et al., 2015).
Cognitive Therapies: Thinking Is Believing
15.5 Summarize the goals and basic elements of cognitive and
cognitive-behavioral therapies.
Cognitive therapy (Beck, 1979; Freeman et al., 1989) was developed by Aaron T. Beck
and is focused on helping people change their ways of thinking. Rather than focus-
ing on the behavior itself, the cognitive therapist focuses on the distorted thinking
and unrealistic beliefs that lead to maladaptive behavior (Hollon & Beck, 1994), espe-
cially those distortions relating to depression (Abela & D’Allesandro, 2002; McGinn,
2000). The goal is to help clients test, in a more objective, scientific way, the truth of
their beliefs and assumptions, as well as their attributions concerning both their own
behavior and the behavior of others in their lives. to Learning Objective 12.9.
Then they can recognize thoughts that are distorted and negative and replace them
with more positive, helpful thoughts. Because the focus is on changing thoughts
rather than gaining deep insights into their causes, this kind of therapy is primarily
an action therapy.
BECK’S COGNITIVE THERAPY
What are these unrealistic beliefs?Cognitive therapy focuses on the distortions of thinking. to Learning Objec-
tive 13.5. Here are some of the more common distortions in thought that can create
negative feelings and unrealistic beliefs in people:
- Arbitrary inference: This refers to “jumping to conclusions” without any evidence.
Arbitrary means to decide something based on nothing more than personal whims.
Example: “Suzy canceled our lunch date—I’ll bet she’s seeing someone else!” - Selective thinking: In selective thinking, the person focuses only on one aspect
of a situation, leaving out other relevant facts that might make things seem less
negative. Example: Peter’s teacher praised his paper but made one comment about
needing to check his punctuation. Peter assumes that his paper is lousy and that
the teacher really didn’t like it, ignoring the other praise and positive comments. - Overgeneralization: Here a person draws a sweeping conclusion from one inci-
dent and then assumes that the conclusion applies to areas of life that have nothing
to do with the original event. Example: “I got yelled at by my boss. My boyfriend is
going to break up with me and kick me out of the apartment—I’ll end up living in
a van down by the river.”
cognitive therapy
therapy in which the focus is on help-
ing clients recognize distortions in
their thinking and replacing distorted,
unrealistic beliefs with more realistic,
helpful thoughts.